Thursday, June 9, 2011

Test and Treat…if we are serious about defeating the spread of HIV/AIDS

The Centers for Disease Control and Prevention (CDC) published the first mention of the disease we will later call HIV in June 1981. Thirty years later, the worldwide pandemic is not over, not globally, not in the United States, and not locally. That means many of us have lived our entire adult lives under the specter of HIV. And yet, with all the progress and all the innovations:

• More than one million people are living with HIV in the United States.

• 56,300 Americans become newly infected with HIV each year.

• Every nine and a half minutes, someone in the United States is infected with the HIV virus.

• More than 640,000 people living with HIV -- many of whom know their status -- are not in medical care or taking life-saving medications. This also means their viral loads are not yet “undetectable,” making it easier to transmit the virus.

• One in five (20%) of those people who are living with HIV are unaware they have the disease, and unaware of their potential to infect others.

• Today, HIV/AIDS continues to devastate some of our nation’s communities: men who have sex with men (MSM), communities of color (especially African-Americans, who, despite being only 12% of the population represent almost 50% of new infections), women (27% of new infections) and low-income individuals and families.
Looking backward helps us remember and understand the dark devastation and loss of the years before protease inhibitors and the difference made by life-saving, life-prolonging drugs. Looking at today’s statistics remind us of where we are… and what we have not yet achieved. Looking forward from here is the work of understanding and implementing an action plan for HIV/AIDS for the next generation.

One strategy critical to the success of defeating the virus is the Test & Treat strategy. HIV is a communicable disease. Defeating it means reducing the possibility of transmission to another person.

Reducing transmission means ensuring that the people who become infected are able to access the medications and care that will reduce their viral loads to undetectable – making it very difficult to transmit the virus. That means everybody has to testregularly and routinely – and then re-test 6-12 months later. That’s not happening nearly enough.

HIV testing has to become routine, just like checking blood pressure, annual physicals, mammograms, pap smears, screens for prostate cancer and the other health tests we do routinely. That means testing has to be widely available, easily accessed, and affordable; not difficult to locate, nor shrouded in mystery, stigma and fear. One in five people who are infected don’t know it. We have to do better than that.
And the second half of the Test & Treat strategy is equally important – Treat. Once someone knows they have been infected they have to be connected to easily accessed, affordable care, including medications. As many as one in four of the people who know they are infected are not connected to care…which likely means their viral loads are NOT undetectable and the risk of transmission is high.

Test & Treat is vital and we can’t afford any more delays. We can’t afford to reduce HIV testing and outreach to the untested – in fact we need to increase it. We can’t afford cuts to HIV care and treatment or HIV medications – in fact we need to make it easier to get care. Some say we can’t afford it. Really? Let’s not keep kicking this can down the road. We can pay the costs of reducing infections and good public health policy now, or we can pay the enormous costs of treating full blown AIDS in hundreds of thousands more Americans later. Either way we’ll pay; let’s be smarter about it.

June 27, 2011 is an opportunity to help move the Test and Treat strategy forward – National HIV Testing Day. Go get tested, take your friends and family – make it routine, make it easy, de-mystify it. Take the rapid test and know the results in just 30 minutes…no more waiting around for 2 weeks. Some of the local HIV testing options can be found here, or just make a doctor’s appointment with your own health care provider.

Just do it …and bring the people you care about with you.